Sweden’s state epidemiologist, Anders Tegnell, is in the news again, defending himself from accusations that his laissez-faire approach to Covid-19 led to thousands of unnecessary infections and deaths.

“Now, we are two years into this and Sweden doesn’t really stand out,” Tegnell told the Financial Times. “We are not the best, but we are definitely not the worst. That is what I hear now: how much good did all these draconian [measures] do for anybody?”

Tegnell reportedly stressed Sweden’s low number of excess deaths. Compared with Europe as a whole, it is true that the impact of the Covid-19 pandemic in Sweden has not been particularly severe. Since January 2020, the country has experienced a total of 831 excess deaths per million people, compared with 650 in Germany, 1,022 in France and 1,801 in the UK.

Compared with its nearest neighbours, however, Sweden’s Covid-19 pandemic has been catastrophic. Denmark has seen just 19 excess deaths per million since January 2020, while Norway has in fact seen fewer deaths than usual over the course of the pandemic.

Which way would Sweden have turned?

The question for the Swedish commission currently investigating Tegnell’s strategy is whether, if it had locked down, Sweden would have experienced rates of infection and death more comparable to Denmark or to the UK.

Fortunately, there is no need to speculate. A study by researchers from Imperial College London, published in Nature in August, modelled the hypothetical first wave death totals in Sweden, the UK and Denmark in scenarios where each country adopted the others’ lockdown strategies.

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Denmark closed its borders on 14 March, three days after recording its first death from Covid-19, and implemented a full lockdown two days later. The UK saw its first death from the virus on 5 March, but did not implement a full lockdown until three weeks later.

The study’s modelling was based on the trajectory of each country’s pandemic before the introduction of restrictions, and the change in this trajectory after the introduction of restrictions.

The researchers found that Sweden would have cut its death rate during the first wave by three-quarters if it had adopted a UK-style lockdown, saving about 4,100 lives. Had the country adopted a stricter, Danish-style lockdown, the death rate could have been cut by 78%.

The UK’s decision to delay its lockdown, relative to Denmark, was estimated to have cost about 26,700 lives. Had the UK elected to follow Sweden’s example and delay action even further, the researchers estimated, the decision would have come at the cost of about 25,000 additional deaths.

Early on in the pandemic, Sweden’s government opted to let the country’s public health agencies set the response to Covid-19. Led largely by Tegnell, Sweden’s health agencies chose not to encourage social distancing or mask-wearing during the pandemic’s first wave, and did not mandate the shuttering of high streets or the cancellation of public events.

Despite the lack of a formal lockdown, Swedish citizens did voluntarily choose to reduce their public activities during the height of the pandemic. Sweden’s economy contracted by 2.7% in 2020, significantly less than the UK (9.8%) but more than neighbouring Denmark (2.1%) or Norway (0.8%), according to the World Bank.